POS1231 IMPAIRED HEALTH-RELATED QUALITY OF LIFE IN PATIENTS WITH IDIOPATHIC INFLAMMATORY MYOPATHIES: A CROSS-SECTIONAL ANALYSIS FROM AN INTERNATIONAL E-SURVEY
Authors: A. Yoshida, Y. LI, V. Maroufy, M. Kuwana, N. Ravichandran, A. Makol, P. Sen, J. B. Lilleker, V. Agarwal, S. Kardes, J. Day, M. Milchert, M. Joshi, T. A. Gheita, B. Salim, T. Velikova, A. E. Gracia-Ramos, I. Parodis, E. Nikiphorou, A. L. Tan, A. Nune, L. Cavagna, M. A. Saavedra, S. Katsuyuki Shinjo, N. Ziade, J. Knitza, O. Distler, H. Chinoy, V. Agarwal, R. Aggarwal, L. Gupta
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Comprehensive and large-scale assessment of health-related quality of life in patients with idiopathic inflammatory myopathies (IIMs) worldwide is lacking. The second COVID-19 vaccination in autoimmune disease (COVAD-2) study [1] is an international, multicentre, self-reported e-survey assessing several aspects of COVID-19 infection and vaccination as well as validated patient-reported outcome measures (PROMs) to outline patient experience in various autoimmune diseases (AIDs), with a particular focus on IIMs. <h3>Objectives</h3> To investigate physical and mental health in a global cohort of IIM patients compared to those with non-IIM autoimmune inflammatory rheumatic diseases (AIRDs), non-rheumatic AIDs (NRAIDs), and those without AIDs (controls), using Patient-Reported Outcome Measurement Information System (PROMIS) global health data obtained from the COVAD-2 survey. <h3>Methods</h3> Demographics, AID diagnoses, comorbidities, disease activity, treatments, and PROMs were extracted from the COVAD-2 database. The primary outcomes were PROMIS Global Physical Health (GPH) and Global Mental Health (GMH) scores. Secondary outcomes included PROMIS physical function short form-10a (PROMIS PF-10a), pain visual analogue scale (VAS), and PROMIS Fatigue-4a scores. Each outcome was compared between IIMs, non-IIM AIRDs, NRAIDs, and controls. Factors affecting GPH and GMH scores in IIMs were identified using multivariable regression analysis. <h3>Results</h3> A total of 10,502 complete responses from 1582 IIMs, 4700 non-IIM AIRDs, 545 NRAIDs, and 3675 controls, which accrued as of May 2022, were analysed. Patients with IIMs were older [59±14 (IIMs) <i>vs</i>. 48±14 (non-IIM AIRDs) <i>vs</i>. 45±14 (NRAIDs) <i>vs</i>. 40±14 (controls) years, p&lt;0.001] and more likely to be Caucasian [82.7% (IIMs) <i>vs</i>. 53.2% (non-IIM AIRDs) <i>vs</i>. 62.4% (NRAIDs) <i>vs</i>. 34.5% (controls), p&lt;0.001]. Among IIMs, dermatomyositis (DM) and juvenile DM were the most common (31.4%), followed by inclusion body myositis (IBM) (24.9%). Patients with IIMs were more likely to have comorbidities [68.1% (IIMs) <i>vs</i>. 45.7% (non-IIM AIRDs) <i>vs</i>. 45.1% (NRAIDs) <i>vs</i>. 26.3% (controls), p&lt;0.001] including mental disorders [33.4% (IIMs) <i>vs</i>. 28.2% (non-IIM AIRDs) <i>vs</i>. 28.4% (NRAIDs) <i>vs</i>. 17.9% (controls), p&lt;0.001]. GPH median scores were lower in IIMs compared to NRAIDs or controls [13 (interquartile range 10–15) IIMs <i>vs</i>. 13 (11–15) non-IIM AIRDs <i>vs</i>. 15 (13–17) NRAIDs <i>vs</i>. 17 (15–18) controls, p&lt;0.001] and PROMIS PF-10a median scores were the lowest in IIMs [34 (25–43) IIMs <i>vs</i>. 40 (34–46) non-IIM AIRDs <i>vs</i>. 47 (40–50) NRAIDs <i>vs</i>. 49 (45–50) controls, p&lt;0.001]. GMH median scores were lower in AIDs including IIMs compared to controls [13 (10–15) IIMs <i>vs</i>. 13 (10–15) non-IIM AIRDs <i>vs</i>. 13 (11–16) NRAIDs <i>vs</i>. 15 (13–17) controls, p&lt;0.001]. Pain VAS median scores were higher in AIDs compared to controls [3 (1–5) IIMs <i>vs</i>. 4 (2–6) non-IIM AIRDs <i>vs</i>. 2 (0–4) NRAIDs <i>vs</i>. 0 (0–2) controls, p&lt;0.001]. Of note, PROMIS Fatigue-4a median scores were the highest in IIMs [11 (8–14) IIMs <i>vs</i>. 8 (10–14) non-IIM AIRDs <i>vs</i>. 9 (7–13) NRAIDs <i>vs</i>. 7 (4–10) controls, p&lt;0.001]. Multivariable regression analysis in IIMs identified older age, male sex, IBM, comorbidities including hypertension and diabetes, active disease, glucocorticoid use, increased pain and fatigue as the independent factors for lower GPH scores, whereas coexistence of interstitial lung disease, mental disorders including anxiety disorder and depression, active disease, increased pain and fatigue were the independent factors for lower GMH scores. <h3>Conclusion</h3> Both physical and mental health are significantly impaired in patients with IIMs compared to those with non-IIM AIDs or those without AIDs. Our results call for greater attention to patient-reported experience and comorbidities including mental disorders to provide targeted approaches and optimise global well-being in patients with IIMs. <h3>Reference</h3> [1]Fazal ZZ, Sen P, Joshi M, et al. COVAD survey 2 long-term outcomes: unmet need and protocol. <i>Rheumatol Int</i>. 2022;<b>42</b>:2151–58. <h3>Acknowledgements</h3> The authors are grateful to all respondents for completing the questionnaire. The authors also thank The Myositis Association, Myositis India, Myositis UK, the Myositis Global Network, Cure JM, Cure IBM, Sjögren's India Foundation, EULAR PARE for their contribution to the dissemination of the survey. Finally, the authors wish to thank all members of the COVAD study group for their invaluable role in the data collection. <h3>Disclosure of Interests</h3> Akira Yoshida: None declared, Yuan Li: None declared, Vahed Maroufy: None declared, Masataka Kuwana Speakers bureau: Boehringer Ingelheim, Ono Pharmaceuticals, AbbVie, Janssen, Astellas, Bayer, Asahi Kasei Pharma, Chugai, Eisai, Mitsubishi Tanabe, Nippon Shinyaku, Pfizer, Consultant of: Corbus, Mochida, Grant/research support from: Boehringer Ingelheim, Ono Pharmaceuticals, Naveen Ravichandran: None declared, Ashima Makol Consultant of: Boehringer-Ingelheim, Parikshit Sen: None declared, James B. Lilleker: None declared, Vishwesh Agarwal: None declared, Sinan Kardes: None declared, Jessica Day Grant/research support from: CSL Limited, Marcin Milchert: None declared, Mrudula Joshi: None declared, Tamer A Gheita: None declared, Babur Salim: None declared, Tsvetelina Velikova: None declared, Abraham Edgar Gracia-Ramos: None declared, Ioannis Parodis Grant/research support from: Amgen, AstraZeneca, Aurinia Pharmaceuticals, Eli Lilly, Gilead Sciences, GlaxoSmithKline, Janssen Pharmaceuticals, Novartis, and F. Hoffmann-La Roche, Elena Nikiphorou Speakers bureau: Celltrion, Pfizer, Sanofi, Gilead, Galapagos, AbbVie, Eli Lilly, Consultant of: Celltrion, Pfizer, Sanofi, Gilead, Galapagos, AbbVie, Eli Lilly, Grant/research support from: Pfizer, Eli Lilly, Ai Lyn Tan Speakers bureau: AbbVie, Gilead, Janssen, Eli Lilly, Novartis, Pfizer, UCB, Consultant of: AbbVie, Gilead, Janssen, Eli Lilly, Novartis, Pfizer, UCB, Arvind Nune: None declared, Lorenzo Cavagna: None declared, Miguel A Saavedra Consultant of: AbbVie, GlaxoSmithKline, Samuel Katsuyuki Shinjo: None declared, Nelly Ziade Speakers bureau: AbbVie, Boehringer-Ingelheim, Eli Lilly, Janssen, Pfizer, Roche, Consultant of: AbbVie, Boehringer-Ingelheim, Eli Lilly, Janssen, Pfizer, Roche, Grant/research support from: AbbVie, Boehringer-Ingelheim, Eli Lilly, Janssen, Pfizer, Roche, Johannes Knitza: None declared, Oliver Distler Speakers bureau: AbbVie, Amgen, Bayer, Boehringer Ingelheim, Janssen, Medscape, Novartis, Consultant of: 4P-Pharma, AbbVie, Acceleron, Alcimed, Altavant, Amgen, AnaMar, Arxx, AstraZeneca, Baecon, Blade, Bayer, Boehringer Ingelheim, Corbus, CSL Behring, Galderma, Galapagos, Glenmark, Gossamer, iQvia, Horizon, Inventiva, Janssen, Kymera, Lupin, Medscape, Merck, Miltenyi Biotec, Mitsubishi Tanabe, Novartis, Prometheus, Redxpharma, Roivant, Sanofi, Topadur, Grant/research support from: AbbVie, Amgen, Boehringer Ingelheim, Kymera, Mitsubishi Tanabe, Novartis, Roche, Hector Chinoy Grant/research support from: Eli Lilly, UCB, Vikas Agarwal: None declared, Rohit Aggarwal Consultant of: Mallinckrodt, Octapharma, CSL Behring, Bristol Myers-Squibb, EMD Serono, Kezar, Pfizer, AstraZeneca, Alexion, Argenx, Boehringer Ingelheim (BI), Corbus, Janssen, Kyverna, Roivant, Merck, Galapagos, Actigraph, Abbvie, Scipher, Horizontal Therapeutics, Teva, Biogen, Beigene, ANI Pharmaceutical, Nuvig, Capella, CabalettaBio, Grant/research support from: Bristol Myers-Squibb, Pfizer, Mallinckrodt, Janssen, Q32, EMD Serono, Boehringer Ingelheim, Latika Gupta: None declared.